Individual
LAURIE POLNEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
17269 NW BROKEN TOP DR, BEAVERTON, OR 97006-4857
(562) 537-7147
Mailing address
17269 NW BROKEN TOP DR, BEAVERTON, OR 97006-4857
(562) 537-7147
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
201406189RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163WC1500X
—
OR
Enumeration date
03/13/2016
Last updated
03/13/2016
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